Type 1 and pregnant for the 1st time at 42

#1

I joined this group about a year ago, but haven't really been active. I have been trying to get pregnant for the last 3 1/2 yrs. I am 42 yrs old and have been Type 1 since the age of 25. We started fertility treatments and are scheduled for a frozen embryo transfer on 10/30. I am so worried about having a healthy pregnancy with my age and being diabetic. I did get pregnant 2 years ago and got my A1c down to 5.8, but it was HARD work. Since that time, my A1c has been in the 7.1 - 7.4 range. All my doctors have given me the green light to go forward, but I am still anxious and nervous. I am looking for some inspiration. Any other older moms with diabetes who have experienced pregnancy willing to share some positive insight?

#2

Oh, and I should add the pregnancy 2 yrs ago resulted in a miscarriage. Thought to be from chromosomal problems, not diabetes.

#3

Hi kdandcm, Your situation is so much like what I went through that I did a double take when I read it. I am 44 now and gave birth to my daughter one week before my 44th birthday (my daughter is now 7 months old.) My husband and I tried for years to get pregnant. I finally got pregnant as soon as we saw the first fertility specialist. We were going to start treatment as soon as I got my period and it never started. We thought we had dodged the bullet. That pregnancy ended in a miscarriage at 9 weeks. I found out at the end that I was pregnant with twins and that the second fetus never really grew. The first one struggled to grow from the start. The pregnancy was deemed "not viable." I was 41. We started IVF about 6 months afterwards. I produced 18 eggs but all had significant genetic abnormalities (we did genetic testing on them.) Rather than go through that again, we opted for the frozen embryo route. We changed doctors to do this. The new fertility doc found a genetic abnormality that I had that had caused the miscarriage and would've prevented any other pregnancy. (You can check my page for the previous threads and the info on that.) I took heparin for that abnormality for the frozen embryo transfer. I ended up pregnant! We used just one of the frozen embryos. We had 6 embryos but only 3 made it through the "defrosting" period. The other two were refrozen. The pregnancy itself was fairly easy till the end. I stayed with the fertility doc till close to the end of the first trimester. I transitioned over to my OB and the perinatologist. The only issue during the first trimester was a major bleeding episode where I thought I had miscarried. I forget the clinical term but basically it was a pocket of blood in the uterus that ruptured. It had no effect on the baby. I stayed active and exercised regularly until the seventh month. I started retaining water and the exercise was getting harder to do. I did a lot of walking at night (this really helped with the numbers) and also walking in the pool at my gym. This helped with the swelling in my feet. By the end of the pregnancy I had gained 40 pounds-15 pounds were water. My feet were REALLY swollen. My blood pressure started creeping up as well. I normally have a good BP. The OB was testing me at every office visit for preeclampsia. They were concerned about this because of the swelling and the blood pressure. My thyroid numbers also started getting out of balance. I started a very low dose of thyroid meds in the last few weeks of the pregnancy. The perinatologist and OB wanted me to deliver in week 39. They did not want me going full term. The baby was always at very healthy measurements and there were no issues there. In week 37 they decided to do a 24 hour urine collection to check for preeclampsia. It came back very high. The doc called me and said I had to deliver that night. I had a C-section later that night. My daughter had never dropped into position so we were already preparing for a C-section. My beautiful baby girl was born on 3/21 weighing 7 pounds 11 ounces. Her blood sugars dropped as soon as she was born (normal in a baby of a diabetic mom) and she immediately went to the NICU. She was released from there 36 hours later. I developed cellulitis and my incision was very painful for awhile. I also had a pocket of fluid that started leaking from the incision (THAT scared the crap out of me) but it was not painful and the doctor drained it for me. Within 6 weeks of giving birth I was within 10 pounds of my pre pregnancy weight. It took several weeks for the water that I had retained to go away. During the pregnancy I was able to keep the A1c below 6. My insulin resistance steadily climbed the entire time. I wear a pump and CGM and those two devices made the pregnancy so much easier. I still tested 10 times a day though. Before getting pregnant I was very worried about the diabetes and the complications that could happen. The issues that I did have had nothing to do with diabetes though. Being pregnant and in your 40's is not easy, but you are carrying an egg that should be very, very healthy. THAT is a huge part of keeping a healthy pregnancy right there. Keeping your blood sugar in line is tough, but trust me, you will be super motivated to keep your numbers down. You've already been through a horrible loss and that is a huge motivator. I wish you good luck for your transfer on Thursday! Let me know how it goes. If you have any questions or need anything, feel free to reach out to me anytime. My doctors refer to my daughter as "The Miracle Baby." She truly is. This entire process will be one of the hardest things you will ever go through. But the pay off will make it all worth while. Good luck!!!!

#4

Thank you so much for the thoughtful reply, Jackie, and for sharing your story! I currently have a pump and I am looking into getting a CGM. I am very nervous, but you are right, I will be super motivated to keep my numbers down. I was amazed that I actually had an a1c of 5.8 for the first pregnancy. Transfer day is tomorrow!! I am so excited! I will keep you posted!! Fingers and toes crossed!!

#5

Try and get the CGM as soon as you can. I had a harder time getting used to the CGM than I did with the pump. Maybe it was just me. When I did my transfer, I stayed off my feet for close to five days- I think they only tell you 2-4 days, but I was extra cautious. I stayed in bed or in a recliner watching TV all that time. I also stopped strenuous exercise until I was out of the first trimester. My main exercise was walking those first weeks. Also, the actual implantation itself can cause some spotting so don't freak out if you start to spot! If you read this before you head to the doctor, don't put on any perfume, cream, lotion, deodorant or anything scented. The embryo's are very sensitive to odor's. I will keep everything crossed for you!! GOOD LUCK!!!!!

#6

Thanks Jackie! The transfer went great! We transferred one grade 5AB blast!! I stayed off my feet for the first two days, but then did venture out for a bit on Saturday. My blood sugars have been high in the morning and then become easier to manage in the late afternoon/evening hours. Any good ideas for a low carb breakfast that is easy to pack for work? I have an appt with my Endo on Thursday this week to discuss my basal rates. I have just been testing pretty much every 30 mins or so and correcting as needed. I did hear from my endo office today about the Dexcom CGM, so hopefully that will happen sooner rather than later. The RN said she would have my Endo Doc signed off on the paperwork today. The next week and a half is going to be so hard!! I am trying to resist the urge to POAS!!! Thanks for the support!!!

#7

Congratulations on the transfer!! When do you go in for your pregnancy test? My doc told me not to do the home test because you could get a false negative if you took it too early. But I took the test anyway! As for low carb breakfast ideas, maybe you could try Glucerna shakes? Or even Slimfast. You'd have to compare the labels to see which will give you what you need. Also try yogurt. Greek or regular-I am partial to regular yogurt. I always had a nonfat yogurt in the morning. My mornings have always been my lower blood sugar times. I did have to cut back and eventually give up OJ in the morning when I was pregnant. It was spiking me way too high towards the end. Different foods will hit you differently now. I tried prune juice (which had more carbs than the OJ) and it was like drinking water-it had almost no impact on my numbers. You may need to experiment with your foods. Your body/blood sugar is going to start reacting much differently now. As my numbers started going up, I would correct it by upping my basal rate by 10-20% increments temporarily. If it worked, I would adjust my permanent basal rate up. If I was spiking after meals, I would change my carb ratio. Talk to your endo about that and your insulin sensitivity and active insulin time settings on your pump. They'll change during a pregnancy though probably not this soon. Even with my CGM, I was still testing 10 times a day. You may need to have your endo change your prescription for test strips if it is not written to test that frequently. Overall, I seem to remember my numbers steadily climbing while I was on the IVF meds in the first trimester. Once I came off the meds, they dropped a bit the started climbing again. Everyone is different, don't stress if your numbers don't do what everyone else has experienced! Keeping my fingers crossed for you!!

#8

Hi Jackie!

I am officially 5w5d preggers!! I had crazy high betas - 1st was 6,895 and the 2nd was 10,871! I went for our first u/s on Monday and we saw the gestational sac with the yolk sac. Hopefully we will see the heartbeat on Tuesday next week. I am still working on getting a CGM, but my numbers are starting to level out (with lots of work!!). I did have a crazy low BS episode this morning where I almost lost consciousness. This has NEVER happened to me before and I was very scared. I called my endo and he made a few basal changes, so hopefully tomorrow morning is better. Hope all is well!!

#9

I AM SOOOO HAPPY FOR YOU!!!! I had been wondering about you and how everything was turning out. I am glad to hear that it is going well! You're a little early to hear a heartbeat but I know that they will be measuring the yolk sac. Once I had a positive pregnancy test, my endo made me get a glucagon kit. I've never used one before and didn't have to during the pregnancy. My doc warned me about being careful if I got too low and passed out. He said that the paramedics would give me a dose of glucagon to revive me but that I would also shoot really high because of the glucagon. That would not be good for the baby. Get used to the basal changes-they'll be happening fairly frequently now!! Will your endo or the high risk specialist be monitoring your numbers?? (CONGRAT'S AGAIN!!)

#10

kdandcm and Jackie,

I want to thank both of you for your post. I also had to do a double take. I am also in my 40s (43) and just over 5 weeks pregnant. I had a miscarriage in December of 2013. And I am type 1.

We do not have any other children.

I found your posts the morning of my first appointment. It’s early and so there was not much to see but everything they could seems fine. I am going to a high risk obstetrix practice and I think they try to be under enthusiastic. I really should not have been given an appointment until about 8 weeks. I return in two weeks to make sure there is a heartbeat.

My A1C is good but still finding the right combination to get my between meal levels below 120. I am hovering at 150.

I hope everything is going well for you. I hope to be able to take this journey with someone with similar circumstances.

#11

Jackie,

Thank you so much for your post. It provided the encouragement I needed. I am 43 and pregnant with type 1. I miscarried in December of 2013 at 6 weeks. I am just over 5 weeks and hope to see a heart beat on my next visit at 7 weeks.

#12

Thanks Jackie! And I am so happy you found this post! I am currently 7w4d and everything looks great so far. We saw the heartbeat last week and again this week. It's 140 and the baby is measuring right on track!

Jackie's response to my post came at just the right time and I was and continue to be so grateful for her support.

I am struggling more than a bit with my numbers. I communicate with my endo team at least 2 x's per week and upload my pump info via diasend for them to review every other day. I am really struggling with my after meal numbers, but they are being very conservative as I also have lows during the day. My fasting BS has been on the low side btw 60-70, which is an improvement from a few weeks ago when it was btw 100-200. It is HARD work, but I know the end result will be amazing. My A1c is still 7, so I do have some more work to do. I am on injectable progesterone and estrace pills to support the pregnancy and the meds have really played havoc with my numbers.

I am hoping to get a CGM...it should be here in the next week! Navigating all the insurance requirements were a pain in the rear and delayed the process, but I am hopeful this will help manage my BS more efficiently. I did ask my endo to increase my RX for test strips. Just in time too as my RX is not due to be filled again for a month and I am almost out of strips!

Good luck with you upcoming u/s. Keep me posted. I also would love to take this journey with someone in similar circumstances!

#13

Hi Jackie J!
So glad that you found our posts! I know how alone I felt when I was going through my IVF cycle. There were others that were doing IVF too, but none that were my age and with my history. Knowing that there are others out there that have experienced the same issues that you are facing makes it all seem a little less scary and isolating. When I went to the high risk specialist at the beginning of the first pregnancy, I had the same reaction you did. The doc even said that they don’t normally see someone until they know that the pregnancy is viable. Not what I needed to hear at the time, especially since it did end in a miscarriage. Because of what we went through, my husband and I were very guarded with our emotions when the second pregnancy happened. My fertility doc was taken aback by my lack of emotion at first. Once I saw the heartbeat for the first time though, I just shut down for a couple minutes then eventually started crying. We never had a heartbeat the first time. Every doctor visit afterwards was stressful until I heard the heartbeat. As for your numbers, get used to the fluctuation. Just when you think you have it figured out, it changes again! If you are on fertility meds, they will impact your numbers as well, sort of like taking a low dose steroid. I can’t honestly say that it gets easier, but you will learn how to adjust things yourself and cope with it all a little better. Sounds like you are doing a pretty good job anyway! Keep up the good work and let us know how everything is going for you. I will keep you in my prayers! (All 9 months!!)

#14

Jackie,

Thank you for your support. I think we are also very cautious. We talk about it in the abstract. I think the 7 week appointment will make us feel much better. And just getting past 6 weeks which is when I miscarried last year (during this same month of December).

We were on the verge of beginning fertility treatments (clomid) but did not end up doing it. I really did not feel I had the courage and stamina for what I knew It would take. I admire you for the emotional strength it takes for IVF.

We might as well have been on a fertility regimen. But we were certainly doing all the charting, testing, temp taking, etc. Last month I was too tired to continue. I had decided to wait to have children and realized I may have to live with that decision and be without children. It must have been the lack of stress that did the trick.

#15

kdandcm,

I am so happy for your heartbeat! I know you will get those numbers under control. Let me know how you like the CGM.

I have resisted a pump for years but I am willing to do it for the baby. I have figured some things out and today was my best in terms of numbers. But I feel whatever I try is only good of a day or two and then my body changes. But I have only been at it a week.

Over the years, I have been able to get away with my bad habits but balancing them with some good ones because my overall A1Cs were good.

But this pregnancy is having none of that! I have been exposed. I have had to go back and really relearn being a diabetic. What has really helped is taking my insulin before I eat, pacing my eating (eating ever 2 to 3 hours is very difficult for me) and a snack before bed.

But as you and Jackie have noted, it's hard. What works today seems to not always work the next day.

#16

I am sad to report that today's ultra sound showed no fetal pole or heartbeat. I am 7 1/2 weeks along. There was no growth in the sac. I have no cramping or bleeding but the ultrasound showed indications of bleeding.

I am doing actually better than someone may expect. I think we kept expectations low because of my past MC and other variables (age, diabetes, fibroids). DH and I never looked too far past this appointment. We knew it would be a critical milestone.

But it's still difficult because although this is further than the first MC, the timing of this happening near Christmas is almost the exact dates of the last MC. And although downplayed, this was verging on seeming real since we were at 7 1/2 weeks.

And my diabetes was under control. I was on a rhythm (although hard) with hitting my target numbers.

I was given the option of a D&C, taking a pill, or letting it happen naturally. I opted for the pill but now I am rethinking that. And I don't really have a good reason; maybe wishful thinking. With my last MC I opted for it to occur naturally. I was at 5 weeks.

#17

I am so sorry Jackie. To have to go through a miscarriage not once but twice, especially this time of the year is…I can’t think of an appropriate word. To say it’s cruel doesn’t even begin to describe it. I was at the same point in my pregnancy when I was told the same as you. My doctor wanted me to do a D&C. He did not want me to experience the actual miscarriage on Christmas Day. I had one final ultrasound done the day before just to be sure. I was not given the pill option. Having the D&C was the better option for me. Waiting for the MC to happen would’ve too much for me. Take some small comfort that you did everything that you could. Your diabetes was well controlled. You were obviously taking care of yourself. I just wish there was something else that I could tell you that could make this all a little better. The only thing I can come up with is this-everything happens for a reason. I thought my MC and how it all unfolded was so unfair and beyond cruel. How could any type of God let this happen? I didn’t make any peace with it until my daughter was born. I look at her and she is absolutely perfect to me. Had I not had that miscarriage, she would not be here. And that thought is unbearable to me. I wish things had turned out differently but not at the expense of not having her. I hope that you reach that same conclusion some day with whatever the future holds for you. One last thing that gave me comfort was a quote that I found about a lost pregnancy. The quote went something like “and the Angel said as they wrote my baby’s name down and softly closed the book, too beautiful for this earth.” You’ll be in my thoughts and prayers Jackie.

#18

Thank you Jackie. I really appreciate you taking the time to provide kind words and sharing such honest, personal experiences. There is the emotional drain that is happening now and second guessing past decisions (underestimating the difficulty of waiting to have children). And I think part of that includes the fear of what next--try again (and if so to what extent); adopt; accept the blessings in our life as is, without children, and find other ways to enrich it.

"I hope that you reach that same conclusion some day with whatever the future holds for you." I am sure I will and will get to a point of releasing trying to completely control the future.

And I will continue to pray and be happy for those like kdandcm who have worked so hard to have a baby.

#19

Wow! Such a great story Jackie that led to a successful birth! Congrats and I hope you are enjoying motherhood!